Recommended practices for the development and evaluation of eHealth interventions

Context Global spread and adoption of mobile health interventions has prompted an unprecedented shift in the provision and utilisation of healthcare. Despite the growth and promise of eHealth, no established best methodological practices exist for their Design and Evaluation. Research-based design and development approaches often lack the agility and capacity to keep up with swift digital innovation led by tech giants. Rigorous evaluation of efficacy often slows the process further. Methods We will present outcomes of the development of three digital interventions informed by participatory design workshops, and their evaluation through randomised controlled trials (RCTs). We discuss observations from backend data capture to discuss adherence to intervention and effectiveness of RCTs. Results For instance, in one of the presented studies, backend data shows that of 169 participants, 84 (50%) did not download, or did/could not use the app; while the rest used it up to 71 times within a month (median =2). Results from the rest of the studies show similar adherence rates. Therefore, we discuss issues of concept development and eHealth evaluation and propose considerations and best practice. Conclusions Developing high quality effective eHealth interventions requires multi-disciplinary expertise, agile design and development practices. While technological innovation propels eHealth, research methodologies should be re-examined to ensure end user safety and longevity of new interventions.